儿童患者胼胝体切开术疗效的系统评价_Journal of Epilepsy

Authors：

GrahamDavid , MTisdallMartin ,  GillDeepak , 张乐 , 慕洁

Corresponding author：

GillDeepak, Email: deepak.gill@health.nsw.gov.au

Keywords：

胼胝体切开术; 儿童; 癫痫; 手术效果; 系统评价

DOI：

10.7507/2096-0247.20170040

Video：

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胼胝体切开术是一种针对全面性或者多灶性难治性癫痫和创伤性跌倒发作的姑息性神经外科手术治疗方式。此研究针对儿童患者的文献进行系统评价。系统检索了发表在Medline, Embase, Web of Knowledge和Scopus上的关于胼胝体切开术治疗效果的文章。纳入患者为手术时年龄＜18岁且中位随访时间＞1年的研究，同时进行了手术切除的研究被排除。总共12篇文章符合纳入标准。除了1篇是前瞻性研究外，其他所有文章均为回顾性研究，研究者对于发作控制良好的标准很少一致。在使用Engel分级标准的文章中，发现与胼胝体前部切开术相比，胼胝体全程切开术的患者发作减少的可能性更大(58.6% vs. 88.2%, P＜0.05), 其中跌倒发作比其他全面性发作类型减少更多。除1例患者被报道死亡以外，其他报道的并发症都很轻微。胼胝体全程切开术的一过性的失连接综合征比胼胝体前部切开术更高(12.5% vs. 0%, P＜0.05)。生活质量、行为、智商和发育商的提高以及父母满意度与发作控制效果大致相关。术后抗癫痫药物的数量没有改变。胼胝体全程切开术更可能减少发作。胼胝体前部切开术不大可能导致失连接综合征。虽然所有的研究得到了相似结论，但证据质量较低。这些证据最多支持了胼胝体切开术是一种安全有效的难治性全面性癫痫治疗方式这一假设，仍需要更多的随机病例对照试验证实。

Citation： GrahamDavid, MTisdallMartin, GillDeepak, 张乐, 慕洁. 儿童患者胼胝体切开术疗效的系统评价. Journal of Epilepsy, 2017, 3(3): 257-266. doi: 10.7507/2096-0247.20170040 Copy

1.	Asadi-Pooya AA, Sharan A, Nei M, et al. Corpus callosotomy. Epilepsy Behav, 2008, 13(7):271-278.
2.	Van Wagenen WP, Herren RV. Surgical division of commissural pathways in the corpus callosum: relation to spread in an epileptic attack. Arch NeurolPsychiatr, 1940, 44(10):740-759.
3.	Erickson TC. Spread of the epileptic discharge: an experimental study of the after-discharge induced by the electrical stimulation of the cerebral cortex. Arch NeurolPsychiatr, 1940, 43(5):429-452.
4.	Wilson DH, Reeves A, Gazzaniga M. Division of the corpus callosum for uncontrollable epilepsy. Neurology, 1978, 28(5):649-653.
5.	Sperry RW, Gazzaniga MS, Bogen JE. Interhemispheric relationships: the neocortical commissures; syndromes of hemisphere disconnection. In Vinken PJ, Bruyn GW (Eds) Handbook of clinical neurology. Amsterdam: North-Holland Publishing Company, 1969:273-290.
6.	Guenot M. Surgical treatment of epilepsy: outcome of various surgical procedures. Rev Neurol, 2004, 160(Suppl 5):5S241-5S250.
7.	Tellez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain, 2005, 128(10):1188-1198.
8.	Jalilian L, Limbrick DD, Steger-May K, et al. Complete versus anterior two-thirds corpus callosotomy in children: analysis of outcome. JNeurosurgPediatr, 2010, 6(2):257-266.
9.	Tanriverdi T, Olivier A, Poulin N, et al. Long-term seizure outcomeafter corpus callosotomy: a retrospective review of 95 patients. J Neurosurg, 2009, 110(7):332-342.
10.	Kawai K, Shimizu H, Yagishita A, et al. Clinical outcomes of corpuscallosotomy in patients with bihemispheric malformations of corticaldevelopment. J NeurosurgPediatr, 2004, 101(4):7-15.
11.	Maehara T, Shimizu H. Surgical outcome of corpus callosotomy inpatients with drop attacks. Epilepsia, 2001, 42(6):67-71.
12.	Hader WJ, Bezchlibnyk I, Pillay N, et al. Corpus callosotomy, risksand benefits: a systematic review of the evidence. Epilepsy Curr, 2012, 12(Suppl 1): S400.
13.	Rolston JD, Englot DJ, Wang D, et al. Corpus callostomy versus vagusnerve stimulation for atonic seizures and drop attacks: a systematicreview. Epilepsy Behav, 2015, 51(7):13-17.
14.	Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Br Med J, 2009, 339(4):b2535.
15.	Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement forreporting systematic reviews and meta-analyses of studies that evaluatehealthcare interventions: explanation and elaboration. Br Med J, 2009, 339(11):b2700.
16.	Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of theInternational League Against Epilepsy. Epilepsia, 1989, 30(3):389-399.
17.	Hader WJ, Tellez-Zenteno J, Metcalfe A, et al. Complications of epilepsy surgery: a systematic review of focal surgical resections andinvasive EEG monitoring. Epilepsia, 2013, 54(4):840-847.
18.	Higgins JPT, Green S (editors). Cochrane handbook for systematicreviews of interventions version 5.1.0 [updated March 2011]. London:The Cochrane Collaboration; 2011. Available at: www.cochrane-handbook.org. Accessed March 15, 2015.
19.	Cukiert A, Cukiert CM, Burattani JA, et al. Long-term outcomeafter callosotomy or vagus nerve stimulation in consecutiveeprospective cohorts of children with Lennox-Gastaut or Lennox-likesyndrome and non-specific MRI findings. Seizure, 2013, 22(10):396-400.
20.	Jea A, Vachhrajani S, Johnson KK, et al. Corpus callosotomy in children with intractable epilepsy using frameless stereotactic neuronavigation: 12-year experience at the Hospital for Sick Children inToronto. Neurosurg Focus, 2008, 25(1):e7.
21.	You SJ, Kang H-C, Ko T-S, et al. Comparison of corpus callosotomyandvagus nerve stimulation in children with Lennox-Gastaut syndrome. Brain Dev, 2008, 30(7):195-199.
22.	Rahimi SY, Park YD, Witcher MR, et al. Corpus callosotomy for treatment of pediatric epilepsy in the modern era. PediatrNeurosurg, 2007, 43(7):202-208.
23.	Rathore C, Abraham M, Rao RM, et al. Outcome after corpus callosotomy in children with injurious drop attacks and severe mental retardation. Brain Dev, 2007, 29(7):577-585.
24.	Turanl G, Yalnizoglu D, Genc-Ac kgoz D, et al. Outcome and longterm follow-up after corpus callosotomy in childhood onset intractableepilepsy. Childs NervSyst, 2006, 22(4):1322-1327.
25.	Shimizu H. Our experience with pediatric epilepsy surgery focusing oncorpuscallosotomy and hemispherectomy. Epilepsia, 2005, 46(Suppl.1):30-31.
26.	Hoadie M, Musharbash A, Otsubo H, et al. Image-guided, framelessstereotactic sectioning of the corpus callosum in children with intractable epilepsy. PediatrNeurosurg, 2001, 34(11):286-294.
27.	Shimizu H, Maehara T. Neuronal disconnection for the surgical treatment of pediatric epilepsy. Epilepsia, 2000, 41(9):S28-S30.
28.	Pinard JM, Delalande O, Chiron C, et al. Callosotomy for epilepsyafter West syndrome. Epilepsia, 1999, 40(7):1727-1734.
29.	Yang T-F, Wong T-T, Kwan S-Y, et al. Quality of life and life satisfaction in families after a child has undergone corpus callosotomy. Epilepsia, 1996, 37(2):76-80.
30.	Cendes F, Ragazzo PC, da Costa V, et al. Corpus callosotomy in treatment of medically resistant epilepsy: preliminary results in a pediatricpopulation. Epilepsia, 1993, 34(10):910-917.
31.	Spencer D, Spencer SS. Corpus callosotomy in the treatment of medically intractable secondarily generalized seizures of children. CleveClin J Med, 1989, 56(2):S69-S78.
32.	Iwasaki M, Uematsu M, Nakayama T, et al. Corpus callosotomyforchildren with intractable generalized epilepsy: factors for long-termseizure remission. No to Hattatsu, 2013, 45(8):195-198.
33.	Durnford AJ, Rodgers W, Kirkham FJ, et al. Very good inter-rater reliability of Engel and ILAE epilepsy surgery outcome classifications in aseries of 76 patients. Seizure, 2011, 20(6):809-812.
34.	Fern andes IS, An S, Loddenkemper T. Pediatric refractory epilepsy: adecision analysis comparing medical versus surgical treatment. Epilepsia, 2015, 56(9):263-272.
35.	Guyatt GH, Oxman AD, Vist G, et al. GRADE guidelines: 4. Ratingthe quality of evidence-study limitations (risk of bias). J ClinEpidemio, l 2011, 64(3):407-415.
36.	Wiebe S, Blume WT, Girvin JP, et al. A randomized, controlled trialof surgery for temporal lobe epilepsy. N Engl J Med, 2001, 345(2):311-318.
37.	Engel J, McDermott MP, Wiebe S, et al. Early surgical therapy fordrug resistant temporal lobe epilepsy: a randomized trial. J Am MedAssoc, 2012, 307(7):922-930.
38.	Engel J, Thompson PM, Stern JM, et al. Connectomics and epilepsy.CurrOpinNeurol, 2013, 26(3):186-194.

1. Asadi-Pooya AA, Sharan A, Nei M, et al. Corpus callosotomy. Epilepsy Behav, 2008, 13(7):271-278.
2. Van Wagenen WP, Herren RV. Surgical division of commissural pathways in the corpus callosum: relation to spread in an epileptic attack. Arch NeurolPsychiatr, 1940, 44(10):740-759.
3. Erickson TC. Spread of the epileptic discharge: an experimental study of the after-discharge induced by the electrical stimulation of the cerebral cortex. Arch NeurolPsychiatr, 1940, 43(5):429-452.
4. Wilson DH, Reeves A, Gazzaniga M. Division of the corpus callosum for uncontrollable epilepsy. Neurology, 1978, 28(5):649-653.
5. Sperry RW, Gazzaniga MS, Bogen JE. Interhemispheric relationships: the neocortical commissures; syndromes of hemisphere disconnection. In Vinken PJ, Bruyn GW (Eds) Handbook of clinical neurology. Amsterdam: North-Holland Publishing Company, 1969:273-290.
6. Guenot M. Surgical treatment of epilepsy: outcome of various surgical procedures. Rev Neurol, 2004, 160(Suppl 5):5S241-5S250.
7. Tellez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain, 2005, 128(10):1188-1198.
8. Jalilian L, Limbrick DD, Steger-May K, et al. Complete versus anterior two-thirds corpus callosotomy in children: analysis of outcome. JNeurosurgPediatr, 2010, 6(2):257-266.
9. Tanriverdi T, Olivier A, Poulin N, et al. Long-term seizure outcomeafter corpus callosotomy: a retrospective review of 95 patients. J Neurosurg, 2009, 110(7):332-342.
10. Kawai K, Shimizu H, Yagishita A, et al. Clinical outcomes of corpuscallosotomy in patients with bihemispheric malformations of corticaldevelopment. J NeurosurgPediatr, 2004, 101(4):7-15.
11. Maehara T, Shimizu H. Surgical outcome of corpus callosotomy inpatients with drop attacks. Epilepsia, 2001, 42(6):67-71.
12. Hader WJ, Bezchlibnyk I, Pillay N, et al. Corpus callosotomy, risksand benefits: a systematic review of the evidence. Epilepsy Curr, 2012, 12(Suppl 1): S400.
13. Rolston JD, Englot DJ, Wang D, et al. Corpus callostomy versus vagusnerve stimulation for atonic seizures and drop attacks: a systematicreview. Epilepsy Behav, 2015, 51(7):13-17.
14. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Br Med J, 2009, 339(4):b2535.
15. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement forreporting systematic reviews and meta-analyses of studies that evaluatehealthcare interventions: explanation and elaboration. Br Med J, 2009, 339(11):b2700.
16. Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of theInternational League Against Epilepsy. Epilepsia, 1989, 30(3):389-399.
17. Hader WJ, Tellez-Zenteno J, Metcalfe A, et al. Complications of epilepsy surgery: a systematic review of focal surgical resections andinvasive EEG monitoring. Epilepsia, 2013, 54(4):840-847.
18. Higgins JPT, Green S (editors). Cochrane handbook for systematicreviews of interventions version 5.1.0 [updated March 2011]. London:The Cochrane Collaboration; 2011. Available at: www.cochrane-handbook.org. Accessed March 15, 2015.
19. Cukiert A, Cukiert CM, Burattani JA, et al. Long-term outcomeafter callosotomy or vagus nerve stimulation in consecutiveeprospective cohorts of children with Lennox-Gastaut or Lennox-likesyndrome and non-specific MRI findings. Seizure, 2013, 22(10):396-400.
20. Jea A, Vachhrajani S, Johnson KK, et al. Corpus callosotomy in children with intractable epilepsy using frameless stereotactic neuronavigation: 12-year experience at the Hospital for Sick Children inToronto. Neurosurg Focus, 2008, 25(1):e7.
21. You SJ, Kang H-C, Ko T-S, et al. Comparison of corpus callosotomyandvagus nerve stimulation in children with Lennox-Gastaut syndrome. Brain Dev, 2008, 30(7):195-199.
22. Rahimi SY, Park YD, Witcher MR, et al. Corpus callosotomy for treatment of pediatric epilepsy in the modern era. PediatrNeurosurg, 2007, 43(7):202-208.
23. Rathore C, Abraham M, Rao RM, et al. Outcome after corpus callosotomy in children with injurious drop attacks and severe mental retardation. Brain Dev, 2007, 29(7):577-585.
24. Turanl G, Yalnizoglu D, Genc-Ac kgoz D, et al. Outcome and longterm follow-up after corpus callosotomy in childhood onset intractableepilepsy. Childs NervSyst, 2006, 22(4):1322-1327.
25. Shimizu H. Our experience with pediatric epilepsy surgery focusing oncorpuscallosotomy and hemispherectomy. Epilepsia, 2005, 46(Suppl.1):30-31.
26. Hoadie M, Musharbash A, Otsubo H, et al. Image-guided, framelessstereotactic sectioning of the corpus callosum in children with intractable epilepsy. PediatrNeurosurg, 2001, 34(11):286-294.
27. Shimizu H, Maehara T. Neuronal disconnection for the surgical treatment of pediatric epilepsy. Epilepsia, 2000, 41(9):S28-S30.
28. Pinard JM, Delalande O, Chiron C, et al. Callosotomy for epilepsyafter West syndrome. Epilepsia, 1999, 40(7):1727-1734.
29. Yang T-F, Wong T-T, Kwan S-Y, et al. Quality of life and life satisfaction in families after a child has undergone corpus callosotomy. Epilepsia, 1996, 37(2):76-80.
30. Cendes F, Ragazzo PC, da Costa V, et al. Corpus callosotomy in treatment of medically resistant epilepsy: preliminary results in a pediatricpopulation. Epilepsia, 1993, 34(10):910-917.
31. Spencer D, Spencer SS. Corpus callosotomy in the treatment of medically intractable secondarily generalized seizures of children. CleveClin J Med, 1989, 56(2):S69-S78.
32. Iwasaki M, Uematsu M, Nakayama T, et al. Corpus callosotomyforchildren with intractable generalized epilepsy: factors for long-termseizure remission. No to Hattatsu, 2013, 45(8):195-198.
33. Durnford AJ, Rodgers W, Kirkham FJ, et al. Very good inter-rater reliability of Engel and ILAE epilepsy surgery outcome classifications in aseries of 76 patients. Seizure, 2011, 20(6):809-812.
34. Fern andes IS, An S, Loddenkemper T. Pediatric refractory epilepsy: adecision analysis comparing medical versus surgical treatment. Epilepsia, 2015, 56(9):263-272.
35. Guyatt GH, Oxman AD, Vist G, et al. GRADE guidelines: 4. Ratingthe quality of evidence-study limitations (risk of bias). J ClinEpidemio, l 2011, 64(3):407-415.
36. Wiebe S, Blume WT, Girvin JP, et al. A randomized, controlled trialof surgery for temporal lobe epilepsy. N Engl J Med, 2001, 345(2):311-318.
37. Engel J, McDermott MP, Wiebe S, et al. Early surgical therapy fordrug resistant temporal lobe epilepsy: a randomized trial. J Am MedAssoc, 2012, 307(7):922-930.
38. Engel J, Thompson PM, Stern JM, et al. Connectomics and epilepsy.CurrOpinNeurol, 2013, 26(3):186-194.

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